Thanks for sharing that. Just a note that that abstract for that study says it uses data from 1999–2004 for patients with PSA levels from 0.1 to 2.0. As far as I know, those predate the ultrasensitive PSA test (or at least its wide availability). I haven't yet found a study mentioning major metastases with undetectable levels in the uPSA test (< 0.01, or sometimes even lower), but am keeping my eyes open.

Regardless, even for the old data with the less sensitive PSA tests, they were looking at something that happened only very rarely.